Death rates from valvular heart disease among U.S. adults ages 65 and older have reversed a nearly two-decade decline, rising from 104 to more than 109 deaths per 100,000 people between 2018 and 2023, according to preliminary research presented at the American Heart Association’s Scientific Sessions 2026. The findings, which have not yet been peer-reviewed, project that death rates will remain around 109 per 100,000 through 2040 rather than resuming their previous downward trend.
The study analyzed more than 1.2 million heart valve disease-related deaths from 1999 to 2023 using the U.S. Centers for Disease Control and Prevention’s WONDER database. After reaching a low just before the pandemic, death rates climbed again, reaching 109.2 per 100,000 in 2023. The burden was highest among men (124.7 per 100,000), non-Hispanic white adults (122.4 per 100,000), adults ages 85 and older, and residents of nonmetropolitan areas (120.5 versus 110.1 per 100,000 in metropolitan areas).
“The decades-long decline in deaths from heart valve disease has stopped,” said study author Hritvik Jain, M.D., a resident physician in internal medicine at Allegheny General Hospital in Pittsburgh. “As the U.S. population continues to age, we need to focus on earlier detection, timely treatment and equitable access to specialized valve care, particularly for the oldest adults and those living in rural communities.”
The research matters because it signals a reversal of progress at a time when treatment options for valve disease have advanced substantially. More than 80 million people worldwide live with heart valve disease, and in the U.S. the condition contributes to more than 57,000 deaths each year, according to the American Heart Association’s 2026 Heart Disease and Stroke Statistics. The study used Joinpoint regression software to assess trends and forecast mortality through 2040.
Researchers also found that while death rates improved for newer generations in their late 60s, those gains did not continue into very old age. Adults 85 and older had more than 15 times the death rate of those ages 65 to 69 in 1999, and newer generations at that age had higher death rates than earlier generations.
“The recent reversal of progress in valvular heart disease mortality is especially alarming in light of the substantial advances in treatment achieved over the past decade and a half,” said Sreekanth Vemulapalli, M.D., a volunteer member of the American Heart Association’s Target: Aortic Stenosis Scientific Advisory Group and an associate professor of medicine at Duke University. “This disconnect between therapeutic innovation and population-level outcomes highlights the critical need for the American Heart Association’s quality improvement and educational initiatives to improve awareness, care delivery and patient outcomes.”
The American Heart Association has launched programs to address the gap, including Target: Aortic Stenosis™ in 2020 and the Heart Valve Initiative in 2025. The study’s limitations include reliance on death-certificate data, which may contain coding inaccuracies and cannot capture disease severity or treatment history. The findings are considered preliminary until published in a peer-reviewed journal. The research was presented at Scientific Sessions 2026, and the abstract is available online.
